Provider Demographics
NPI:1861166035
Name:THOMAS, PAIGE MARIE-ANGELA (OD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:MARIE-ANGELA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-412 KAHUANANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3512
Mailing Address - Country:US
Mailing Address - Phone:808-258-8725
Mailing Address - Fax:
Practice Address - Street 1:3802 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4940
Practice Address - Country:US
Practice Address - Phone:425-339-5436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61182654152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist